DJP Update 4-18-2010 A potpourri of recent DJPNEWS tweets & some special recommendations; LAGNIAPPE: must read quotes from 1949 book re government control of medicine
Be sure to go to the links and read these two articles “Why the Wild Bird Sings” and “I think, therefore I will not be gagged”; reflect on implication for listening and applying science! And of course, “Gotcha” and the “NHS” articles.
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http://twitter.com/djpNEWS
DJPNEWS
Study history & monitor current gov systems #hcr“NHS bars woman after she saw private doctor” #TheTimes http://tinyurl.com/y6e5jpp
3 minutes ago via web
Read! #TheTimes “I think, therefore I will not be gagged” author #SimonSingh freedom of speech advocate http://tinyurl.com/y2ymhwk
10 minutes ago via web
Pulitzer Prize-winning #KathleenTurner praises Sen @ScottBrownMA as “indep.” & a “good guy” FaceTheNation http://tinyurl.com/y5lq4x6
18 minutes ago via web
Senator @ScottBrownMA the equivalent of “Mr. Smith Goes to Washington”? Watch him on Meet the Press http://tinyurl.com/y83lpt8
20 minutes ago via web
Thanks! RT @B_Ivory #FF @DJPNEWS ..current news health reform & other update notif.. w/ the gov ..im ..reading his book “On Leadership”
about 13 hours ago via Echofon in reply to B_Ivory
Pearls for #musicians “Why the wild bird sings” #Times of London & lesson listening hidden meanings http://tinyurl.com/y5wro9t
about 17 hours ago via web
More on #hcr includes #NYT readers- Overhaul Law: Gotcha By Grace-Marie Turner of @galeninstitute http://tinyurl.com/y5l9wet
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LAGNIAPPE: Some quotes from 1949 book, “Compulsory Medical Care and The Welfare State” by Melchior Palyi mentioned in previous DJP Update. The book was a gift from Dr W. Juan Watkins.
The author makes the case for an objective analysis and the scientific approach when evaluating medical systems in different countries.
Chapter Eight: “The doctors are, of course, the key figures of governmentalized medicine.” …. “Even the cost of administration is dependent in part upon the degree of control over the profession. And what is more important than all cost problems–the welfare of the patient is in the doctor’s hands.”
“Governmentalized health services sooner or later run into the iron curtain of mountainous costs. the easiest way out is to curtail honoraria, denouncing the doctors as profiteers. That may or may not be true, but it is both popular and money saving.” …
“As to the young specialist in Britain, his chances are equally reduced unless he enjoys a bureaucratic existence and the political game. To start a new private practice is virtually out of the question. The same holds in many other compulsory systems. Wherever the doctor is being paid by the authorities and not by the patients, the outcome of compulsion is a set of fees that does not cover the investment in expensive instruments. This has the additional effect that could scarcely have been unintended: it forces the patient into governmentally controlled dispensaries which can afford the investment–at the taxpayer’s expense.”
Chapter Nine: Here is an excerpt from a conversation with a “distinguished member of the Netherlands’ ‘social’ bureaucracy”:
Question: “How much time can a practitioner devote to each of them?”
Answer: “We figure on an average of three minutes per consultation. What is wrong with that? An experienced physician does not need more time on the average.
Question: “That includes the time devoted to paper work such as fulling out forms for sending the patient to a specialist or to a hosptial, writing out prescription, etc.?”
Answer: “It does.”
Also in Chapter nine, in subsection entitled, “Doctors’ Surrender”
“The source of greatest weakness in the doctors’ position is the fact of their readiness to compromise. A minority of them actually advocates compulsion, and even the majority is willing to cooperate, if only on its own terms.”
… “Instead of taking the position of principle, they argue about technicalities and honoraria, ….
“They overlook two more things, as a rule. Once the principle of compulsion is accepted, the amount and terms are not being determined by the doctors or upon their advice. And even if the terms conform at the outset with the professional proposals, the schemes expand sooner or later far beyond the original intent.”
“In the recent case of Britain, one reason why the doctors’ resistance broke was the fact of defection in the medical ranks themselves. When it came to the showdown on the Bevan scheme, 35 per cent of the profession, including the tip leadership of the British Medical and Dental Associations, capitulated. (A chief executive of the latter has been promptly promoted to a high rank in the Ministry of Health.)”
The author ends that chapter with this comment:
“The moral of this story is that in the final analysis the doctors can blame themselves if they lose out–if their incomes are reduced at once by 25 per cent on the average, as under Bevan, and their professional standards lowered in an unmeasurable fashion–just as a nation can blame itself if it foregoes its liberties, be it by submitting to intimidation or by letting itself be bribed into ‘collaboration.'”
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DJP comment: The excerpts remind us that we must study history. And we must get the facts and use scientific analysis. You be the judge as to whether history is repeating itself.
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Stay well,
Donald
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Donald J. Palmisano, MD, JD
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